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House Opioid Measure Frenzy Continues

Over a period of two weeks in June, the House passed several bills aimed at combating the ongoing opioid epidemic. Our summary of the earlier measures can be found here. Key points of these additional legislative initiatives are summarized below. We will continue to monitor and report on their progress.

R. 3192, CHIP Mental Health Parity Act
This bill required state Children’s Health Insurance Program (CHIP programs) to cover mental health benefits including substance use disorder services for pregnant women and children. It also prohibits states from imposing financial or utilization limits on mental health treatment that are lower than the limits placed on physical health treatment.

R. 3331
Specifically, this bill encourages the Center for Medicare and Medicaid Innovation to test models to provide incentive payments to behavioral health providers for adopting electronic health records technology, and using that technology to improve the quality and coordination of care.

R. 4005, Medicaid Reentry Act
This bill requires a group of stakeholders, convened at the direction of the Secretary of the Health and Human Services, to develop and report to Congress on best practices for addressing issues related to health care faced by those returning to communities from incarceration. Additionally, the legislation allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual’s release.

R. 449, Synthetic Drug Awareness Act of 2017
This bill directs the U.S. Surgeon General to report to Congress on the public health effects of the rise in synthetic drug use among individuals aged 12 to 18 years old in order to further educate parents and the medical community on the health effects of synthetics.

R. 4684, Ensuring Access to Quality Sober Living Act of 2018
The Ensuring Access to Quality Sober Living Act authorizes the Substance Abuse and Mental Health Administration Services to develop, publish, and disseminate best practices for operating recovery housing that promotes a safe environment and sustained recovery from substance use disorders.

R. 5102, Substance Use Disorder Workforce Loan Repayment Act of 2018
This bill creates a loan replacement program for substance use disorder treatment providers. Specifically, the legislation offers student loan repayment of up to $250,000 for participants who agree to work as substance use disorder treatment professionals in underserved areas. The program is available to direct care providers including physicians, registered nurses, social workers, and other behavioral health professionals.

R. 5176, Preventing Overdoses While in Emergency Rooms Act of 2018
The Secretary of the Department of Health and Human Services must develop protocols and a grant program for health care providers that addresses the needs of people who survive a drug overdose. The protocols would also consider the provisions of naloxone upon discharge and the referral to treatment and other services that best fit the patient’s needs.

R. 5228, Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now Act
This bill provides the Food and Drug Administration with stronger recall and seizure authority to disrupt the entry of counterfeit and illicit drugs through International Mail Facilities (IMFs), which receive millions of parcels containing illegal or unapproved drugs annually.

R. 5261, TEACH to Combat Addiction Act of 2018
TEACH to Combat Addiction Act directs the Secretary of HHS to designate regional Centers of Excellence to improve how health professionals are educated in substance abuse disorder prevention, treatment, and recovery by way of development, evaluation, and distribution of evidence-based curricula for health profession schools.

R. 5272, Reinforcing Evidence-Based Standards Under Law in Treating Substance Abuse Act of 2018
Requires the newly established National Mental Health and Substance Use Policy Laboratory to issue guidance to applicants of SAMHSA grants that support evidence-based practices.

R. 5329, Poison Center Network Enhancement Act of 2018
The Poison Center Network Enhancement Act authorizes the national network of Poison Control Centers. In particular, the bill re-authorizes the toll-free number, national media campaign, and grant program created under the Public Health Service Act. It also increases the share of poison control center funding provided through grants.

R. 5583, Requiring Medicaid Programs to Report on All Core Behavioral Health Measures
This bill requires states to include behavioral health indicators in their annual reports on the quality of care under Medicaid. This would take effect in 2024.

R. 5587, Peer Support Communities of Recovery Act
This bill enhances the Comprehensive Addiction and recovery Act’s Building Communities of Recovery Program. It also authorizes the HHS to award grants to peer support specialist organizations for the development and expansion of recovery services. Specifically, the grants would be awarded to nonprofit organizations that support community-based, peer-delivered support.

R. 5590, Opioid Addiction Action Plan Act
The Opioid Addiction Action Plan Act requires the Secretary of HHS to develop an action plan for assessing potential institutional inefficiencies or fixed incentives within Medicare in relation to the opioid crisis. Additionally, the bill would require HHS to convene a stakeholder meeting and issue a request for information within three month of enactment. The plan aims to ensure that Medicare and Medicaid can identify more efficient ways to adapt to innovative treatments for both pain that requires opioid prescriptions and for treatment of substance abuse disorders.

R. 5605, Advancing High Quality Treatment for Opioid Use Disorders in Medicare Act
This bill would provide incentives and funding for care management services using evidence-based treatments and strategies to increase access to opioid use disorder treatments for Medicare beneficiaries. The bill aims to increase coordinated care approaches to opioid addiction that includes psychotherapy, social services, and treatment planning in addition to medication assisted treatment.

R. 5687, Securing Opioids and Unused Narcotics with Deliberate (SOUND) Disposal and Packaging Act of 2018
The SOUND Disposal and Packaging Act would give the Food and Drug Administration (FDA) authority to implement packaging and disposal guidelines aimed at reducing the risk of drug misuse and abuse.

R. 5752, the Stop Illicit Drug Importation Act of 2018
HR 5752 increases the Food and Drug Administration (FDA)’s authority to seize, detain and destroy illegal products being imported into the United States.

R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users’ Treatment (REACH OUT) Act of 2018
The REACH OUT Act authorizes the Secretary of Health and Human Services to award grants for programs aimed at educating “high-volume outlier prescribers” of opioids. These prescribers are those who, compared to other prescribers in their geographic area and medical specialty, prescribe an “excessive” number of opioids. The bill would also provide an incentive for states to adopt medical loss ratio (MLR) requirements for the Medicaid managed care organizations (MCOs) of 85 percent.

R. 5797 IMD CARE Act
HR 5797 allows states to provide opioid use disorder services through Medicaid for individuals in mental health institutions who are between the ages of 21 and 64. State Medicaid programs would be eligible for matching federal funds for services provided by these institutions. Services would be covered for up to 30 days per 12 month period for eligible enrollees. State applications must include specified information, including how their plans would improve access to outpatient care.

R. 5800, Medicaid IMD ADDITIONAL INFO Act
This bill requires Medicaid and CHIP Payment Access Commission (MACPAC) to study state Medicaid standards for medical disease institutions and provide recommendations on best practices and data collection. Under the current law, the federal government cannot provide Medicaid matching funds to states for services provided to Medicaid-eligible individuals between the ages of 21 and 64 who are patients in institutions for mental diseases.

R. 5801, Medicaid PARTNERSHIP Act
The Medicaid PARTNERSHIP Act requires Medicaid providers to check their state prescription drug monitoring program (PDMP) database before prescribing Schedule II controlled substances. The bill also would require state PDMPs to meet minimum requirements, and require state Medicaid programs to report several PDMP metrics to the Centers for Medicare and Medicaid (CMS). The legislation’s goal is to encourage providers to integrate use of their state PDMP into their normal workflow.

R. 5811, to amend the Federal Food, Drug, and Cosmetic Act with respect to postapproval study requirements for certain controlled substances, and for other purposes
HR 5811 aims to address the lack of data studying the long-term efficacy of opioids, the increasing likelihood of addiction over a longer period of time, as well as the role of opioids as part of a pain treatment plan. The bill allows the Food and Drug Administration (FDA) to require pharmaceutical manufacturers to study drugs even after they are approved to assess needed changes to use recommendations and labeling.

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